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摩洛哥卫生和教育部门的公共支出效率（英）

文化传媒 2026-04-01 国际货币基金组织测试专用号1普通版

Morocco's health and education outcomes have improved, with expanded access in recent years. However, persistent challenges include medical personnel shortages, weak learning outcomes, regional disparities, and outdated infrastructure. While public spending in these sectors is relatively high compared to peers, efficiency gaps remain, and budget under-execution is common, indicating potential for better results with existing resources.

Health Sector:

Outcomes: Health-adjusted life expectancy (HALE) at birth is around 62.34 years, comparable to emerging market and regional peers. Infant mortality rates have declined significantly.
Capacity Constraints: Density of health workers per 10,000 inhabitants is 16.09, below WHO's recommended critical density of 23. Hospital bed capacity is 7.3 per 10,000 inhabitants, below the desirable level of 20. Geographical disparities exist, with some regions having only three medical doctors per 10,000 inhabitants.
Expenditures: Current health spending is around 5.7% of GDP, with government spending at 2.3% of GDP. Out-of-pocket spending remains high at 43% of total current health spending.
Efficiency: Spending efficiency is better than in comparator countries in the MENA region and emerging markets, with an efficiency gap of around 0.27. Investment execution rate in the health sector is around 70%.
Reforms: Key areas include universal health care coverage, strengthening human resources, more efficient infrastructure, and strengthening governance. The government has launched comprehensive social protection reforms and is working to modernize hospital infrastructure and expand training capacity.

Education Sector:

Access: Enrollment has increased across all levels, with gross primary enrollment at around 115–117%, secondary enrollment up by 27 percentage points, and tertiary enrollment up by 34 percentage points since 2010. Preschool enrollment has also increased.
Outcomes: Education attainment remains low compared to MENA peers and emerging markets. Morocco scores at the bottom of international PISA assessments in science, mathematics, and reading.
Challenges: Regional inequities, skill mismatches, teacher-related constraints, governance and efficiency weaknesses, and limited decentralization.
Expenditures: Public expenditure on education is around 6% of GDP, well above regional peers and emerging market comparators.
Efficiency: Spending efficiency has improved, but an efficiency gap of around 37% persists, suggesting outcomes could be 37% higher if resources were used more efficiently. Investment execution rate is around 70%, particularly low in higher education, scientific research, and innovation.
Reforms: Key areas include accelerating universal preschool education, improving quality and relevance of learning outcomes, scaling up the "Pioneer School" model, strengthening education infrastructure, and reforming student financial support and school services.

Recommendations:

Health: Accelerate reforms, enhance governance and institutional capacity, fully operationalize key governance institutions, strengthen data and financial management systems, streamline decentralization arrangements, improve human-resource and infrastructure management, and link greater autonomy to clearer accountability.
Education: Strengthen governance, accountability, and execution capacity across the education system. Clarify roles and responsibilities, streamline procurement and approval processes, enhance technical capacity, grant greater school level autonomy, and improve data systems to link resources to learning outcomes.

Public SpendingEfficiency in the Healthand Education Sectors inMorocco Asel Isakova SIP/2026/027 IMF Selected Issues Papers are prepared by IMF staff asbackground documentation for periodic consultations withmember countries.It is based on the information available atthe time it was completed on March 5, 2026. This paper is alsopublished separately as IMF Country Report No 26/73. 2026APR IMF Selected Issues Paper Middle East and Central Asia Department Public Spending Efficiency in the Health and Education Sectors in MoroccoPrepared by Asel Isakova* Authorized for distribution by Laura Jaramillo MayorApril2026 IMF Selected Issues Papersare prepared by IMF staff as background documentation for periodicconsultations with member countries.It is based on the information available at the time it wascompleted on March 5, 2026. This paper is also published separately as IMF Country Report No 26/73. ABSTRACT:Health and education outcomes in Morocco have improved and access has expandedsignificantly in recent years. Nonetheless, long-standing challenges persist—including shortages of medicalpersonnel, weak learning outcomes, regional disparities, and outdated infrastructure. Public spending levels inthese sectors are relatively high compared to peers yet efficiency gaps remain and budget under-execution iscommon, suggesting scope to achieve better results with existing resources. Ambitious reforms to improvecapacity and quality of services in these sectors are currently underway, and need to be accelerated andunderpinned by stronger governance, accountability, and execution capacity to ensure durable gains in quality,equity, and sustainability. This will require fully operationalizing key governance institutions, strengthening dataand financial management systems, streamlining decentralization arrangements, improving human-resourceand infrastructure management, and linking greater autonomy to clearer accountability to ensure that risingspending translates into better service delivery and outcomes. RECOMMENDED CITATION:Isakova, Asel, 2026. Public Spending Efficiency in the Health and EducationSectors. IMF Selected Issues Paper (SIP/2026/027). Washington, D.C. International Monetary Fund Public Spending Efficiency inthe Health and EducationSectors in Morocco Morocco Prepared by Asel Isakova1 MOROCCO SELECTED ISSUES ApprovedByMiddle East andCentral AsiaDepartment Prepared ByAsel Isakova (FAD). CONTENTS PUBLIC SPENDING EFFICIENCY IN THE HEALTH AND EDUCATION SECTORS__2 A. Health ___________________________________________________________________________2B. Education ________________________________________________________________________7 FIGURES 1. Health Outcomes ________________________________________________________________22. Health Sector Capacity Indicators ________________________________________________33. Health Expenditures and Public Spending Efficiency _____________________________54. Access to Education______________________________________________________________85. Education Outcomes_____________________________________________________________96. Education Spending ____________________________________________________________11 References ________________________________________________________________________14 PUBLIC SPENDING EFFICIENCY IN THE HEALTH ANDEDUCATION SECTORS1 Health and education outcomes in Morocco have improved and access has expanded significantlyin recent years. Nonetheless, long-standing challenges persist—including shortages of medicalpersonnel, weak learning outcomes, regional disparities, and outdated infrastructure. Publicspending levels in these sectors are relatively high compared to peers yet efficiency gaps remainand budget under-execution is common, suggesting scope to achieve better results with existingresources. Ambitious reforms to improve capacity and quality of services in these sectors arecurrently underway, and need to be accelerated and underpinned by stronger governance,accountability, and execution capacity to ensure durable gains in quality, equity, andsustainability. This will require fully operationalizing key governance institutions, strengtheningdata and financial management systems, streamlining decentralization arrangements, improvinghuman‑resource and infrastructure management, and linking greater autonomy to cleareraccountability to ensure that rising spending translates into better service delivery and outcomes. A.Health 1.The health outcomes of the Moroccan population have improved over time andcompare well to emerging markets (EM) and regional peers (Figure 1).The health-adjusted lifeexpectancy (HALE) at birth is around 62.34 years, having increased from 60.69 years in 2000, andcomparable to peers among emerging markets and MENA countries. Infant mortality rates havecontinued to decline, falling from over 28 deaths per 1000 live births in 2010 to below 16 in 2023.This is lower than in countries across the MENA region, though i

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